Sleep Disorders In Individuals Research Articles

Non-alcoholic fatty liver disease and sleep disorders.

Studies have shown that non-alcoholic fatty liver disease (NAFLD) may be associated with sleep disorders. In order to explore the explicit relationship between the two, we systematically reviewed the effects of sleep disorders, especially obstructive sleep apnea (OSA), on the incidence of NAFLD, and analyzed the possible mechanisms after adjusting for confounding factors. NAFLD is independently associated with sleep disorders. Different sleep disorders may be the cause of the onset and aggravation of NAFLD. An excessive or insufficient sleep duration, poor sleep quality, insomnia, sleep-wake disorders, and OSA may increase the incidence of NAFLD. Despite that some research suggests a unidirectional causal link between the two, specifically, the onset of NAFLD is identified as a result of changes in sleep characteristics, and the reverse relationship does not hold true. Nevertheless, there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD. Further research is needed to establish a clear relationship between NAFLD and sleep disorders. This will lay the groundwork for earlier identification of potential patients, which is crucial for earlier monitoring, diagnosis, effective prevention, and treatment of NAFLD.

Improvement of autistic-like behaviors in adult rats prenatally exposed to valproic acid through early suppression of orexin receptor.

Autism spectrum disorder (ASD) is a disabling psychiatric disease characterized by impairments in communication and social skills. The pathophysiology of autism is complex and not fully known. Considering the incidence of sleep disorders in individuals with ASD and the important role of orexin in sleep, it is possible to hypothesize that an alteration of the orexinergic system could be implicated in the pathogenesis of autism symptoms. The present study was conducted to investigate the effect of suvorexant [dual orexin receptor antagonists (DORAs)] on autism-like behavior in prenatally valproic acid (VPA)-exposed rats]. Wistar female rats were administered VPA [600 mg/kg, intraperitoneally (i.p.)] or normal saline (10 ml/kg, i.p.; vehicle control) on gestational day 12.5. Thirty-two male offspring were divided into four groups: Control, VPA, Suvorexant+VPA, and VPA+Risperidone. The pups were given suvorexant [20 ml/kg, by mouth/orally (p.o.)] or risperidone (1 ml/kg, p.o.) daily from postnatal day (PND) (40-54). The offspring were tested for repetitive behaviors and cognitive ability with a Y-maze task on PND 55, and social interaction was assessed by play behavior in the open field on PND 56. And anxiety with using the three-chamber social assay on PND 56. In the Y-maze apparatus, spontaneous alteration significantly decreased in the prenatal VPA-treated rats compared to control rats showing autistic-like behavior, and 2-week suvorexant increased the alternation, indicating the beneficial effect of suvorexant. Prenatal treatment with VPA, impaired play behavior (sniffing, grooming, and darting), and increased anxiety-related behavior. Suvorexant treatment attenuated the problems in male offspring's social behavior. Our results showed that suvorexant improved ASD-associated behaviors in the VPA-treated rats, and the orexinergic system may be associated with the pathogenesis of autism symptoms.

EPIGENETIC DIFFERENCE BETWEEN INSOMNIA GROUP AND NONINSOMNIA GROUP IN PARTICIPANTS WITH KNEE PAIN

Abstract Chronic knee pain is a common condition that often co-occurs with insomnia. Epigenetic modifications, such as DNA methylation, may play a role in the sleep-pain relationship. In this study, we aimed to identify differentially methylated CpGs/regions and enriched genomic pathways associated with insomnia in participants with knee pain (KP). We recruited 140 cognitively healthy middle to older-aged adults with self-reported KP and extracted DNA from peripheral blood. MethylationEPIC arrays were used for methylation data quantification, R package minfi was used for data preprocessing and quality control, and Ingenuity Pathway Analysis (IPA) was used to explore functional implications of differential methylation in pathways related to insomnia. Annotated genes within ±5kb of the putative differentially methylated regions (DMRs, p< 0.05) were subjected to the IPA analysis. There were no significant differences in sex or race between the two groups (p>0.05). We observed an over-representation of younger participants in the insomnia group (p=0.005) and also from the University of Florida (p=0.008). At raw p < 0.05 cutoff, we identified a total of 20,006 CpG probes, including 12,674 hypermethylated, and 7,332 hypomethylated CpG probes. Pathway analysis using IPA identified multiple immune-related pathways enriched with insomnia-related differentially methylated regions (DMRs), including the antigen presentation pathway (p=3.39E-08). Verapamil was identified as the most significant upstream regulator (p=8.8E-07). Our findings suggest the importance of epigenetic regulation of the immune system in the sleep-pain relationship and highlight the need for further research to understand the epigenetic contributions to sleep disorders in individuals with chronic pain.

Workshop (Clinical/Best Practice Implementation) ID 2000430

Background/Objectives Sleep disorders are more common among individuals living with spinal cord injury and spinal cord disease (SCI/D) than among non-disabled people. Upon completion of this workshop, attendees will (1) understand the pathophysiology, diagnosis, classification, clinical consequences and management of the most common sleep disorders in non-disabled people; (2) recognise the current knowledge, knowledge gaps, and recently research-generated knowledge on sleep disorders in individuals living with SCI/D; and (3) appreciate the use of an educational tool to raise awareness on sleep disorders among individuals with SCI/D. Methods/Overview This workshop will include two 20-minute lectures with illustrative cases followed by open discussion on the following topics: (i) pathophysiology, diagnosis, classification, clinical consequences and management of the most common sleep disorders in non-disabled people; and (ii) the current knowledge, knowledge gaps, and recently research-generated knowledge on sleep disorders in individuals living with SCI/D. Finally, an example of educational tool on sleep for individuals living with SCI/D will be presented. Results Untreated sleep disorders can have significant short-term and long-term consequences. Early diagnosis and timely treatment is key in the prevention or mitigation of consequences of sleep disorders. Proper management of sleep disorders can have psychosocial and functional impacts on the lives of individuals with SCI/D; it may also mitigate other secondary medical conditions after SCI/D. Finally, there is a pressing need to raise awareness of this issue among individuals living with SCI/D and healthcare professionals. Conclusion Sleep disorders are common and understudied in the SCI/D population. Early diagnosis and proper treatment is key to improve the lives of individuals with SCI/D and, likely, reduce other secondary medical conditions from SCI/D. Raising awareness on sleep disorders among individuals with SCI/D is needed.

Prevalence of Sleep Disorders and Related Factors in Individuals Undergoing Hemodialysis.

The quality of life of individuals undergoing hemodialysis is related to many factors, including sleep disorders. To determine the prevalence of sleep disorders in individuals undergoing hemodialysis and to assess the effect of clinical and biochemical parameters on their sleep quality. We conducted a cross-sectional descriptive survey in multiple hemodialysis centers. Individuals were interviewed using a questionnaire for obtaining general personal information, the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, and the Epworth Sleepiness Scale (ESS) for assessing excessive daytime sleepiness (EDS). The study included 338 individuals with a median age of 55 years. Poor sleep quality (PSQ) and EDS were present in 41.4% and 6.5% of the individuals, respectively. The individuals' PSQI scores were significantly proportional to their ESS scores. Concerns about the disease and its treatment (60.7%) and poor physical conditions (35.7%) were major reported reasons for PSQ. In a logistic regression analysis, female gender, household income, ESS score, chronic heart failure, and creatinine and parathormone levels were found to be independent predictors of PSQ; household income, PSQ presence, parathormone and potassium levels, and urea reduction ratio were found to be independent predictors of EDS. Sleep disorders are common in individuals undergoing hemodialysis and are related to gender, comorbid diseases, poor economic state, altered biochemical values, dialysis timing, and concerns about the disease and its treatment. Improving these individuals' quality of life through adequate psychological and financial support and early diagnosis of sleep disorders should decrease their mortality and morbidity rates.

Family aggregation of sleep characteristics: Results of the Heinz Nixdorf Recall and the Multi-Generation Study.

IntroductionPoor sleep is a risk factor for adverse health events. For health prevention, it may be helpful to know whether poor sleep or sleep disorders in individuals are associated with sleep problems in their partners or children.MethodsIn the MultiGeneration Study (MGS, conducted from 2013 to 2016), 1237 partners (aged 27 to 90 years) and 1660 adult children (aged 18 to 66 years) of index persons were recruited. Index persons are participants of the Heinz Nixdorf Recall Study, a population-based cohort study in the Ruhr area (study start 1999–2001, 4841 participants aged 45–75 years). We used two analysis populations: one with 1181 index persons whose partners were in MGS, and one with 1083 index persons with at least one adult child in MGS. Sleep characteristics were assessed using questionnaires (including the Pittsburgh Sleep Quality Index). The exposure was the presence of a sleep characteristic of the index subject.ResultsChildren showed the investigated sleep characteristics more often if these were also present in their parent (e.g., RR (relative risk) = 1.28 (95% CI: 1.06–1.55) for poor sleep quality). In partners, strong associations were observed for rising times and napping, but only weak associations for snoring, poor sleep quality and sleep disorders. Snoring of the bed partner is a risk factor for poor sleep (e.g., RR = 1.67 (0.91–3.07) for difficulties falling asleep).ConclusionAggregation is observed for many sleep characteristics in people living in partnerships as well as in parents and their adult children.

Computerized Adaptive Testing for Sleep Disorders

Abstract. Background: As more and more people suffer from sleep disorders, the need to develop an efficient, inexpensive, and accurate assessment tool for screening sleep disorders has become more urgent. Aim: The aim of the current study was to develop a system allowing computerized adaptive testing for sleep disorders (CAT-SD). Methods: A large sample ( N = 1,304) was recruited to construct an item bank for CAT-SD and to investigate the psychometric characteristics of CAT-SD. First, analyses of unidimensionality, model fit, item fit, item discrimination parameters, and differential item functioning (DIF) were conducted to construct a final item pool to meet the requirements of item response theory measurement. Then, a simulated CAT study with real data was performed to investigate the psychometric characteristics of CAT-SD, including the reliability, validity, and predictive utility (sensitivity and specificity). Results: The final unidimensional item bank of the CAT-SD had good item fit, high discrimination, and no DIF. Moreover, it had acceptable reliability, validity, and predictive utility. Limitations: Non-statistical assembly constraints, execution environment, construction of item bank, criterion-related validity, and predictive utility (sensitivity and specificity) of CAT-SD, and sample representativeness are discussed. Conclusions: The CAT-SD could be used as an effective and accurate assessment tool for measuring the sleep disorders in individuals and offers a novel approach to the screening of sleep disorders utilizing psychological scales.

Therapeutic Approaches to Insomnia and Fatigue in Patients with Multiple Sclerosis

The prevalence of sleep disorders in individuals with multiple sclerosis (MS) is 3–5 times higher compared to the general population. Insomnia Disorder, defined as difficulty falling asleep, maintaining sleep or waking up too early, can lead to significant fatigue, the most common and disabling symptom of MS. In addition, fatigue and insomnia in patients with MS also can overlap with and exacerbate other psychological and physical symptoms. Cognitive behavioral therapy for insomnia (CBT-I) has been shown as an effective treatment for chronic insomnia and burgeoning research has demonstrated the effectiveness of this treatment for insomnia in individuals with a variety of comorbid medical conditions including MS. The purpose of the current review will explore the literature surrounding the prevalence and impact of sleep disorders and fatigue in MS. Additionally, this review will address practical ways to help individuals with MS manage fatigue as well as how to modify typical standard behavioral treatments for insomnia to take into account special considerations for individuals with MS based on the level of disability and other comorbid issues that impact sleep.

Neurodevelopmental Disorders Commonly Presenting with Sleep Disturbances.

There are multiple disorders of neurodevelopment that present with co-occurring sleep disturbances. Many of these neurodevelopmental disorders (NDD) include sleep disturbances in their diagnostic criteria. Neurobiological, genetic, and environmental factors overlap to cause different sleep disorders in individuals with NDD. Caregivers often present reporting either insomnia or hypersomnia, and based on the clinical history and findings from diagnostic tests, an appropriate diagnosis can be made. It is crucial that clinicians understand the different presentations of sleep disturbances in individuals with NDD.

Mental health care of medical workers during COVID-19 pandemic

During the pandemic caused by the SARS-CoV-2 virus, healthcare workers are at the forefront of the battle undergoing not only significant physical but also emotional stress. At the same time medical workers are considered to be at high risk for the incidence of COVID-19. Staying in a state of constant emotional stress over time leads to the emergence of both mental and somatic disorders. The purpose of this article is to conduct a literature review on the principles of consistency regarding the mental health of staff members of medical institutions providing care to patients with COVID-19. A systematic literature search has been carried out, as a result of which 32 articles with reports of mental and behavioral disorders during the pandemic have been selected for analysis. The main group of disorders are disorders of the anxious-depressive spectrum. According to various sources, from a quarter to a third of medical workers have clinically significant anxiety, about a third – depression. Significant prevalence of sleep disorders in individuals providing medical care to patients with COVID-19 has also been indicated. In the long term, the expectation of an increase in the level of post-traumatic stress disorder has been indicated. The article also provides modern views on the socio-psychological effects of epidemics and pandemics. Excessive attention, especially on social media devoted to the problem of COVID-19 significantly complicates the fight against the real problem of overcoming the pandemic. It has been proven that overconcentration on problems associated with COVID-19 is a factor of the increased risk of developing generalized anxiety disorder in the end. Thus, the protection of mental health and the socio-psychological support of medical workers are some of the important directions in the fight against the coronavirus pandemic. The management of psychological crises during pandemics should be based on psycho-hygienic and psycho-preventive measures both at the level of the individual and society as a whole.

The clinical relevance of early identification and treatment of sleep disorders in mental health care: protocol of a randomized control trial

BackgroundSleep disorders are a risk factor for developing a variety of mental disorders, have a negative impact on their remission rates and increase the risk of relapse. Early identification and treatment of sleep disorders is therefore of paramount importance. Unfortunately, in mental health care sleep disorders are often poorly recognized and specific treatment frequently occurs late or not at all. This protocol-paper presents a randomized controlled trial investigating the clinical relevance of early detection and treatment of sleep disorders in mental health care. The two aims of this project are 1) to determine the prevalence of sleep disorders in different mental disorders, and 2) to investigate the contribution of early identification and adequate treatment of sleep disorders in individuals with mental disorders to their sleep, mental disorder symptoms, general functioning, and quality of life.MethodsPatients newly referred to a Dutch mental health institute for psychiatric treatment will be screened for sleep disorders with the self-assessment Holland Sleep Disorders Questionnaire (HSDQ). Patients scoring above the cut-off criteria will be invited for additional diagnostic evaluation and, treatment of the respective sleep disorder. Participants will be randomly assigned to two groups: Immediate sleep diagnostics and intervention (TAU+SI-T0), or delayed start of sleep intervention (TAU+SI-T1; 6 months after inclusion). The effect of sleep treatment as add-on to treatment as usual (TAU) will be tested with regard to sleep disorder symptoms, general functioning, and quality of life (in collaboration with a psychiatric sleep centre).DiscussionThis trial will examine the prevalence of different sleep disorders in a broad range of mental disorders, providing information on the co-occurrence of specific sleep and mental disorders. Further, this study is the first to investigate the impact of early treatment of sleep disorders on the outcome of many mental disorders. Moreover, standard sleep interventions will be tailored to specific mental disorders, to increase their efficacy. The results of this trial may contribute considerably to the improvement of mental health care.Trial registrationThis clinical trial has been retrospectively registered in the Netherlands Trial Register (NL8389; https://www.trialregister.nl/trial/8389) on February 2th, 2020.

Obstructive sleep apnea syndrome and sleep disorders in individuals with occupational injuries

BackgroundSome sleep disorders are known risk factors for occupational injuries (OIs). This study aimed to compare the prevalence of obstructive sleep apnea syndrome (OSAS) in a population of patients with OIs admitted to the emergency room (ER) with hospital outpatients as controls.MethodsSeventy-nine patients with OIs and 56 controls were recruited at the University Hospital of Basel, Switzerland between 2009 and 2011. All patients completed a questionnaire and underwent a full-night attended polysomnography (PSG). We considered an apnea–hypopnea index (AHI) > 5 as an abnormal finding suggestive of a diagnosis of OSAS.ResultsPatients with OIs did not differ from controls regarding sex, age, body mass index, and job risk of OI. Patients with OIs tended to have an abnormal AHI (n = 38 [48%] vs. n = 16 [29%], odds ratio [OR] = 2.32 [95% confidence interval (CI):1.05–5.13]), and a higher AHI (8.0 vs. 5.6 events/h; Cohen’s d 0.28, p = 0.028) compared with controls. Patients with OIs also had abnormal limb movement index, arousal index, and signs of sleep bruxism compared with controls. Compared with 36 controls (66%), 70 patients with OIs (89%) had either excessive daytime sleepiness (EDS), and/or an abnormal finding during PSG (OR = 4.32, 95% CI:1.65–11.52). However, patients with OIs did not differ from controls regarding EDS or oxygen desaturation index.ConclusionsPatients treated in the ER for OI had more abnormal findings suggestive of OSAS or other sleep disorders compared with a control group of hospital outpatients. Screening for these conditions should be part of the postaccident medical investigation.

The Association between Physical Activity and Sleep Disorders in Adolescents and Young Adults with Down syndrome: A Questionnaire Study

The high prevalence of sleep disorders is well documented in individuals with Down syndrome (DS). Thus, given the robust association between physical activity and sleep disorders in the typical population, more work is needed to examine this association in this population. The total of twenty-nine adolescents and young adults with DS participated in the current study. Parents reported on well-validated questionnaires to measure the levels of physical activity and sleep-related disorders in their children with DS. First, our result indicates that high active participants had lower parental reports of features associated with obstructive sleep apnea (OSA) compared with low active participants. Further, after controlling for age and BMI, the levels of moderate-to-vigorous physical activity showed negative correlations with parental ratings of OSA. Both results suggest physical activity, in particular moderate-tovigorous intensity exercise, may determine the severity of OSA in adolescents and young adults with DS. Therefore, future work should consider the role of physical activity that may reduce the onset of sleep disorders in individuals with DS.

Sleep disturbances and cognitive decline:recommendations on clinical assessment and the management

In 2004, in Genoa (Italy), the Italian Dementia Research Association (SINDem) was born. The first congress of this new scientific society took place in Rome in 2006. SINDem soon recognized the importance to investigate sleep problems in cognitive decline and created a national "sleep study group "composed by neurologists and sleep specialists. In 2012, The SINDem study group, in close relationship with the Italian Association of sleep medicine (AIMS), published the study "Prevalence of sleep disturbances in mild cognitive impairment and dementing disorders: a multicenter Italian clinical cross-sectional study on 431 patients ", confirming the high prevalence of sleep disturbances in a wide Italian population of persons with cognitive decline. The study was supported by a grant from the Italian Minister of Health and was conducted with the fundamental contribution of the Italian National Research Center (CNR). In 2014, the same group published the paper "Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review". The recommendations are wide and directed to professionals (neurologists but not exclusively) to try to establish uniform levels of care, promote collaborative studies into areas of uncertainty, and define the qualitative characteristics of Dementia Reference Centers about sleep disturbances.

Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review.

Clinical assessment and management of sleep disturbances in patients with mild cognitive impairment and dementia has important clinical and social implications. Poor sleep results in an increased risk of morbidities and mortality in demented patients and is a source of stress for caregivers. Sleep disturbances show high prevalence in mild cognitive impairment and dementia patients and they are often associated one to another in the same patient. A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of individuals with cognitive decline. The Sleep Study Group of the Italian Dementia Research Association (SINDem) reviewed evidence from original research articles, meta-analyses and systematic reviews published up to December 2013. The evidence was classified in quality levels (I, II, III) and strength of recommendations (A, B, C, D, E). Where there was a lack of evidence, but clear consensus, good practice points were provided. These recommendations may not be appropriate for all circumstances and should therefore be adopted only after a patient's individual characteristics have been carefully evaluated.

Sleep Disorders in Patients with Traumatic Brain Injury

Traumatic brain injury (TBI) is a global problem and causes long-term disability in millions of individuals. This is a major problem for both military- and civilian-related populations. The prevalence of sleep disorders in individuals with TBI is very high, yet mostly unrecognized. Approximately 46% of all chronic TBI patients have sleep disorders, which require nocturnal polysomnography and the Multiple Sleep Latency Test for diagnosis. These disorders include sleep apnoea (23% of all TBI patients), post-traumatic hypersomnia (11%), narcolepsy (6%) and periodic limb movements (7%). Over half of all TBI patients will have insomnia complaints, most often with less severe injury and after personal assault, and half of these may be related to a circadian rhythm disorder. Hypothalamic injury with decreased levels of wake-promoting neurotransmitters such as hypocretin (orexin) and histamine may be involved in the pathophysiology of excessive sleepiness associated with TBI. These sleep disorders result in additional neurocognitive deficits and functional impairment, which might be attributed to the original brain injury itself and thus be left without specific treatment. Most standard treatment regimens of sleep disorders appear to be effective in these patients, including continuous positive airway pressure for sleep apnoea, pramipexole for periodic limb movements and cognitive behavioural therapy for insomnia. The role of wake-promoting agents and CNS stimulants for TBI-associated narcolepsy, post-traumatic hypersomnia and excessive daytime sleepiness requires further study with larger numbers of patients to determine effectiveness and benefit in this population. Future research with multiple collaborating centres should attempt to delineate the pathophysiology of TBI-associated sleep disorders, including CNS-derived hypersomnia and circadian rhythm disturbances, and determine definitive, effective treatment for associated sleep disorders.

Sleep-Disordered Breathing May Spur Behavioral, Learning Problems in Children

TEN YEARS AGO, MANY OF THE PREschool and elementary schoolaged children referred to the Johns Hopkins University School of Medicine’s pediatric sleep and breathing disorders center, in Baltimore, already had pulmonary hypertension and cardiac problems when they arrived. Today, however, thanks in part to efforts by the National Institutes of Health, sleep specialists, and others to boost recognition of sleep disorders in individuals of all ages, the center now generally sees children with sleepdisordered breathing (SDB) before such severe problems arise, said Ann Halbower, MD, medical director of the school’s pediatric sleep disorders program. But even earlier intervention is needed, Halbower said. “Children with SDB commonly struggle with behavioral and learning difficulties for months, even years, before receiving proper care,” she said.

Sleep Quality and Psychological Adjustment in Chronic Fatigue Syndrome

Without specific etiology or effective treatment, chronic fatigue syndrome (CFS) remains a contentious diagnosis. Individuals with CFS complain of fatigue and poor sleep--symptoms that are often attributed to psychological disturbance. To assess the nature and prevalence of sleep disturbance in CFS and to investigate the widely presumed presence of psychological maladjustment we examined sleep quality, sleep disorders, physical health, daytime sleepiness, fatigue, and psychological adjustment in three samples. individuals with CFS; a healthy control group; and individuals with a definite medical diagnosis: narcolepsy. Outcome measures included physiological evaluation (polysomnography), medical diagnosis, structured interview, and self-report measures. Results indicate that the CFS sample had a very high incidence (58%) of previously undiagnosed primary sleep disorder such as sleep apnea/hypopnea syndrome and restless legs/periodic limb movement disorder. They also had very high rates of self-reported insomnia and nonrestorative sleep. Narcolepsy and CFS participants were very similar on psychological adjustment: both these groups had more psychological maladjustment than did control group participants. Our data suggest that primary sleep disorders in individuals with CFS are underdiagnosed in primary care settings and that the psychological disturbances seen in CFS may well be the result of living with a chronic illness that is poorly recognized or understood.

The role of actigraphy in sleep medicine.

During the last decade actigraphy (activity-based monitoring) has become an essential tool in sleep research and sleep medicine. The validity, reliability and limitations of actigraphy for documenting sleep-wake patterns have been addressed. Normative data on sleep-wake patterns across development have been collected. Multiple studies have documented the adequacy of actigraphy to distinguish between clinical groups and to identify certain sleep-wake disorders. Actigraphy has also been shown to be effective in documenting the effects of various behavioral and medical interventions on sleep-wake patterns. Actigraphy is less useful for documenting sleep-wake in individuals who have long motionless periods of wakefulness (e.g. insomnia patients) or who have disorders that involve altered motility patterns (e.g. sleep apnea). Potential users should be aware of a number of pitfalls of actigraphy: (1) validity has not been established for all scoring algorithms or devices, or for all clinical groups; (2) actigraphy is not sufficient for diagnosis of sleep disorders in individuals with motor disorders or high motility during sleep; (3) the use of computer scoring algorithms without controlling for potential artifacts can lead to inaccurate and misleading results.

A review of the nature and treatment of sleep disorders in individuals with developmental disabilities

This paper describes research on the prevalence, correlates, and treatment of sleep disorders in individuals with developmental disabilities. A significant number of individuals with developmental disabilities have disordered sleep, although prevalence estimates vary from 13% to 86%. Constitutional variables, including age, presence of physical and sensory impairments, and certain genetic syndromes and medical conditions appear to be related to sleep disturbance, but the evidence is mainly correlational and therefore cannot be said to show a causal relation. While a number of behavioral interventions have proven effective in the treatment of sleep disturbance, and drug therapy involving melatonin appears promising, epidemiologic work on the correlates of sleep disorders appear to have had little impact on treatment. Consideration of the nature of sleep disorders may enhance treatments for individuals with developmental disabilities.